| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACADIA BENEFITS INC3 Filed as: ACADIA BENEFITS, INC. | 111 COMMERCIAL ST PORTLAND, ME 04101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $42 | $32K | $32K | 0.63% |
| ARCADIA BENEFITS3 Filed as: ARCADIA BENEFITS INC. | 111 COMMERCIAL ST 5TH FL PORTLAND, ME 04101 | DELTA DENTAL PLAN OF MAINE | $5K | — | $5K | 1.53% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W 11 MILE RD SOUTHFIELD, MI 48034 | DELTA DENTAL PLAN OF MAINE | $482 | — | $482 | 0.14% |
| ARCADIA BENEFITS3 | 111 COMMERCIAL ST 5TH FL PORTLAND, ME 04101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $620 | $3K | 3.40% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W ELEVEN MILE STE 210 SOUTHFIELD, MI 480348203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $33 | $3 | $36 | 0.04% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W 11 MILE RD SUITE 210 SOUTHFIELD, MI 48034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $164 | $10K | 14.74% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 6650 METAIRIE, LA 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $368 | $5K | 6.98% |
| ARCADIA BENEFITS3 | 111 COMMERCIAL ST FL 5 PORTLAND, ME 041014719 | VISION SERVICE PLAN | $1K | — | $1K | 2.71% |
| ARCADIA BENEFITS3 | 111 COMMERCIAL ST 5TH FL PORTLAND, ME 04101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $373 | $2K | 3.43% |
| J.S. CLARK AGENCY, INC.3 Filed as: JS CLARK AGENCY INC | 25900 W ELEVEN MILE STE 210 SOUTHFIELD, MI 480348203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$98 | -$5 | -$103 | -0.19% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,092 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,092 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 736 | $5.1M |
| Dental | DELTA DENTAL PLAN OF MAINE | 1,131 | $356K |
| Vision | VISION SERVICE PLAN | 539 | $55K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,124 | $54K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,124 | $54K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 736 | $5.1M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,124 | $214K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,131 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.